My patella realignment. 27.2.12

[lululocket]

Hi Mom (I can call you that because I'm English so there's no conflict with my own "Mum"  ),

Just checking in to see how things are going... I would try the ice by the way, my physio really encouraged me to keep using it for many weeks to help with swelling, although with a tea towel to protect the skin, and only about 30mins at a time. Hmm I don't really know about the mesh - I googled to find out more and all the links were about hernia surgery so I decided to stay away from that!
Have you had an xray to see how things are healing yet? Best of luck if it is soon. And how is sleeping coming along? I'm now moving a lot more at night so most of my body is more comfortable, but unfortunately my knee hurts more 

Lulu

[momof436]

Hi again. Really tired today. Oh gosh, I ended up googling mom now 

Anyways really tired, long day early start and late finish, came home about 20.30 after work I had to take my two youngest to one of their sports activities and because my S/O is away with our car I ended up taking the bus everywhere  so I'm quite tired now.

I have been moving a lot around though I have not had time to do enough of the exercises I am supposed to do also the one that was pointed out to me last PT session which is basically sitting down and extending the leg up from the floor hurts quite a bit to do!I don't particularly like that one, feel I have to take some painkillers before exercises .
I have decided to sleep without my brace which is bliss cause I can sleep the way I like, and it is bliss for my back then I can finally sleep comfortably.
I have had more pain now as well.Pain sitting down when my knee is at 60 deg.
Yes I had an x ray, it seemed everything was coming along well, I even got a copy of the x ray showing my legbone? with two quite big screws in it, fascinating.
Tomorrow I have an early start again so I better get some sleep... have to catch the bus... but I get to drop by the spa tomorrow, I have actually never been to one before and I don't know how it will go with this leg, but I guess I'll find something relaxing I can do there

[momof436]

oh, the spa was wonderful! I had a neck massage and I have been to saunas and relaxing rooms, I walked around with  my brace but in the end I braved it without, I had to take my crutch in with me into the mineral pool and getting in and out was tricky but I did it I feel so clean and so fresh, on the way home I bought a couple of tops, after  weeks with limited showering it was great! Possibly the most relaxing day I have had that I can remember. 
Now I am reluctantly doing those painful exercises 

[momof436]

Ok today it is seven weeks and a day since my surgery.  I am now walking around without crutches mostly, but still wearing a brace. Actually I can swap between wearing a brace or using crutches.  PT is going approximately as expected. I still have swelling around the ankle and knee. I do get very tired walking around like this, and today I managed to fall into a hole in the pavement, it was just a small hole and I dropped in it wit the other knee not the operated one, which made me not fall down, but fall and collect myself with the operated knee, which hurt some time after. I get really tired feet cause I still use the bus and have to walk to and fro, so I walk for at least 40 minutes every day, then I walk and stand at work, and if I need to do anything in town, so I walk around a lot, which is probably good but I do get exhausted.
My brace has been of interest, especially to kids, who always wonder what have you done with your leg? and even passers by might ask questions.

I'm better at lifting my leg up straight and holding my balance and doing squats or standing on one knee than quad sets or the flexing up, those I think still hurt especially when my legs and knees are tired which they mostly are.

M

[Lorikeet]

That sounds like an awful lot of walking. Surely that must be one of the factors in your swollen knee and ankle. I'm only going on three weeks now so quite a bit behind you...So walking that long seems like a nightmare at this point. Also, my OS ordered me to stop using my crutches and brace  (except when moving around a lot) already so moving about is a slow process indeed. I'm managing but have to concentrate quite hard to avoid falling over. I hope it won't be too much longer until the swelling settles down and you can manage your walking without all the exhaustion and pain.

[lookingforrelief]

Hello there!

I'm in the US, but this is probably the first blog I've gotten too that closely resembles my problem.  Thank you both for your postings!  I am 43...I had a Lateral Release when I was 13 on my left.  Right needed one about 7 yrs after, but never went through with it...then Left knee went again.  

I thought, well it's time.  I went to Orthopedic, and he said Faulkerson on both knees...Later Releases included, and I'm not sure if it includes the MPFL (which it does sound like you had), but there is a more success with that one, so I do hope it is.  Regretfully.  It took a bit of time to digest.  I go back 4.5.12 (I think I did that correctly May 4,2012).

Dr. says my patella is not tracking and you can see it on only one of the 4 that they took...just like the last 2 x-ray's I have had.  This procedure wasn't developed at the time I had the one release, and I believe too new when I was told I needed a release on the Right knee.  

I will check back and post again.  By the way...what are your ages, if you don't mind me asking...unfortunately, harder to heal the older you are..  Thanks again for the posts!  By the way, it is genetic.

[lululocket]

Hi 'looking...'

By 'left knee went again', do you mean dislocation? LR is not used very commonly by itself, usually in conjunction with something like a Fulkerson as on its own it can often just make everything a bit looser and even more vulnerable.

The Fulkerson is a form of TTT, itself a form of osteotomy, which you'll see lots of us talking about on the post op diaries. It can correct certain kinds of patella tracking issues, but you'll see it's a pretty major surgery and needs to be carefully thought through. I felt like I'd been punched in the stomach when I got the news about needing it, I was meant to go back to work and had to sit in a coffee shop first just to calm down. If it is the right procedure though, getting free of dislocations is pretty great.

Also important to understand is whether you fall into the group of normal anatomy who broke something and need realignment (probably not), or my group (welcome!) of ABNORMAL anatomy. I say that because you say it is genetic - like being tall or short, having knees that are too high or low or whatever variant can be passed on. So, you need to be sure that your particular knee shape will be fixed by the op recommended.

I could give a quick summary, but the best thing is to read through EVERYTHING on this list
http://www.kneeguru.co.uk/KNEEnotes/node/1789
Or if you want to be quicker, the important ones, will be the middle chunk of the list, starting at patella tilt...., ending at patella alta.

On the age question - I'm 24 (one TTT 6 weeks ago, and had the first leg done aged 22). My OS encouraged me to have it ASAP since my bones had stopped growing, to reduce the damage I was doing every day and also the risk of yet another dislocation. No doubt healing is a little harder with age, but there are other kinds of osteotomies which can 'deload' damaged areas of bone (HTOs and so on), which are routinely performed on plenty of patients your age and older to delay having a knee replacement. Age is only one factor remember - overall health is worth thinking about too.

Oh, and the MPFL is Medial patellofemoral ligament reconstruction, so it depends if yours is broken or not!

[lookingforrelief]

Thank you for your reply.  Yes, by my comment "left knee went again" was the start of the dislocations again with that leg.  As for the LR, yes - it was done alone, as at the time the Fulkerson had not been developed yet.  And yes, again - I am in the 'abnormal group'. 

I know what you mean by feeling like you were 'punched in the stomach' when you were told.  I still get a sick feeling somethimes thinking about it.  I have been reading quite a bit about it since I was told this was the "fix" for the Tilt and sublaxations.  I had read though that the MPFL is commonly used with the Fulkerson now as it offers more stability than just the Fulkerson.  Just another one of the zillion questions I have for my OS when we meet again in May.  Once he started talking about moving bones, he kind of lost me.  He gave me the name of the procedure and told me to do as much searching on the internet as I could about it.

When I first started researching it took a while just to get it all sorted out in my head.  I have always worked, and it is very demanding - walking on concrete 12 hr. days, with steps also heavily involved.  This will mean that I will no longer have a job.  I do have Short Term Disability, and also have carried Long Term Disability on myself, so I am covered with that for the duration, including the operation on the other leg.  I will be covered on my fiance's insurance once we are married in August (my insurance will cover until approximately September).  It's been a month of searching information, and what I need to be prepard for once the procedure is done.

[Lorikeet]

Hi "looking",

Just thought I'd let you know I'm just turned 47 so it can be done when older. I'm only 3 weeks in today but my recovery has been pretty uneventful so far. My surgeon's protocol has been less conservative than most others I've read about here in that I've been WBAT from the beginning and I've been off crutches and brace for a week now. I still use the brace if I will be doing a lot of walking (which isn't much at this point) but when home I don't use it at all. I should point out that while I did have the TTT and LR and scope, I didn't have the MPFL so that could make a difference on recovery.

[momof436]

Hello All.

Looking; I am 36 years old.  I could have had the surgery about 13 years ago or something like that that is when it was first suggested to me, but I wasn't sure. They did always tell me that PT alone could help me, but tbh. when it comes to me it never did.

I'm not sure about what lateral release is about. I think you guys are very knowledgeable about all these surgeries. I didn't really even know the name of my surgery and not much at all about it.

I am lucky I guess I live in a country where medical care and surgeries are mostly state financed. It's different in th US I hear where you must have insurgence cover.

I will have to write later,,, gotta go..

[momof436]

OK. I think I have reached a limit now I got to say stop and calm down. 
My leg was hurting quite a bit yesterday but in the morning I thought it was probably OK. So I went  to work, but before that I had to take my daughter to the doctor and then take her to the hospital to get an x ray of her elbow just in case because she hurt it yesterday evening and some movements still hurt. So I wlked to the bus, dropped off my youngest at school,then went offto the doc andd from there took the bus and then walked quite a way to the xray ppl. then I took her to school with a taxi and took the bus to work and walked that dreadful half kilometer to work. After about half a day my knee started aching under and at the sideand every time I straighten it it hurts, now I'm at home walked that half kilometerto the bus again and then the couple of hundred meters from the bus and my leg and ankle are quite swollenand the knee too especially the inner knee. So nowI'msitting with my feet up and I'm calling in sick tomorrow. My knee hurts my ankle hurts and my leg hurts.
I feel kind of stupid, but it has seemed to me the way my doctor speaks that my knee is supposed to handle walking around now 
I don't know where the border is that is my problem, where is the border between good exercise and too much, over ladening it?
Where it hurts the most, under the knee about where the screws are there is a tinge of blue like  bruise, but only a little. And my knee feels well just not as good as a couple of days ago.
Now I got to rest it that's for sure. 

[Lorikeet]

You poor thing! So glad you're taking time off tomorrow as it sounds like you really need it. I don't have any answers on overdoing things as I am way behind you and I do have a habit of overdoing it. I guess it's all a matter of noticing body signals telling you to slow down before you go too far. It doesn't help that sometimes it doesn't catch up with you for a few hours either.

Take good care of yourself and feel better soon.

[momof436]

Thanks  Lorikeet.  This day off is doing me good, I feel better today, I felt chills last night I was very tired and maybe a bit feverish, but I'm a lot better today, my leg is no longer swollen, but I have been really just resting  I think it is really hard to know when to stop and just tell my self to take it easy.  I use a sewing machine at work too so it hasn't been great, pressing the pedal with the left foot just does not come automatically 

It's been lovely resting.

Have you had knee surgery before Lorikeet?

M

[Lorikeet]

It's good to hear you are doing so much better today. It's hard to stop yourself doing things when you start to progress in recovery and even harder to realise what your limits are. I find it hard to know how much to push myself to do more and how far to keep going right now. Funny thing is I was quite busy today going to a post-op appointment and lunch with my husband and feel okay now. But yesterday I just did things around the house and was exhausted. Maybe it has to do with what's happening with the healing too.

This is my only knee surgery thus far. I didn't have problems when I was younger, but then I wasn't athletic or particularly active. My right knee is technically worse than my "bad" knee but I haven't been troubled with it so much, aside from it subluxating at times and a very occasional pain problem.

[momof436]

Thanks Hope you are well today too

I don't know with me, I feel I have more pain now than say 3 weeks ago, especially at night. Last night I dreamed my leg was being amputated, because of the pain. I thought maybe it is because I wasn't sleeping with  my brace anymore, so I sleep with it sometimes now. I think mabe it's cause I sleep with my knees bent. I don't know. Maybe it's just the way I move on a day to day basis. I get pain sometimes under the kneecap where the screws are, sometimes behind the knee and sometimes on top of the knee cap on the upper side. It could also be cause I haven't taken painkillers much, it is looking less swollen though.

M